| Name: | |
| Phone Number: | |
| Address: | |
| Email Address: | |
| Have you had a Whippet before?: | |
| Which do you prefer?: | |
| Which gender do you prefer?: | |
| If you have children in the home please list their ages.: | |
| Who will be the primary caretaker of the dog?: | |
| Will someone be home during the day with the dog?: | |
| If not, how long will the dog usually be left alone each day?: | |
| Where will the dog stay while you are away?: | |
| If you go on vacation, what will you do with the dog?: | |
| Please describe the type of home you live in and the local area (house, apartment, condo, urban, rural, suburban....): | |
| Do you own or rent your home?: | |
| If you rent, please provide contact information for your landlord.: | |
| Is your yard fenced?: | |
| If yes, what type of fencing do you have and how tall is it?: | |
| Have you owned dogs in the past?: | |
| If yes, what kind(s) of dog did you own, and what happened: | |
| Do you have any other pets?: | |
| If yes, what kind?: | |
| Please provide the name, address, and phone number of your veterinarian: | |
| Would it be okay for us to call him/her as a reference?: | |
| Which activities do you plan to participate in with your puppy? Please check all that apply. | |
| | Pet Only |
| | Lure Coursing |
| | Conformation |
| | Obedience |
| | Racing |
| | Agility |
| Should your circumstances change so that you were no longer able to care for or keep this dog, will you agree that the dog is to be returned to us?: | |
| Please add anything about yourself and your family or home that will help us find the right dog for you.: | |
| May we share your information with other breeders in order to assist you in finding a puppy?: | |
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